Anesthesia

[mizuno]

I can't seem to find the thread about the different forms of anesthesia.
But, I believe that most doctors use Local Anesthesia with Sedation ?
Can you please verify which do use the majority of the time.
Thanks,
Mizuno

[Dr. Elliot Jacobs]

For the vast majority of my cases, I prefer intra-venous sedation (administered by a separate, board certified MD anesthesiologist) plus local anesthesia (administered by me) and tumescent infiltration.  This allows for a pleasant experience for the patient (gently sleeping but NOT general anesthesia) and adequate pain relief as well.  The patient awakens as the last stitch is placed, and is talking lucidly with no nausea, vomiting, hangover or sore throat (which can occur with general anesthesia).

Some extremely large and difficult cases will undoubtedly required general anesthesia.

And some extremely localized cases (ie tissue just under the areolas) can be handled by local anesthesia alone.  But be advised, local anesthesia is just that -- a bunch of injections which are uncomfortable until everything becomes numb.  Then you are awake and aware of everything as the surgery is performed -- some guys get very uncomfortable with that.

I would not do a moderate or more severe case under local anesthesia alone -- local anesthesia does not block some types of nerves which would be involved during the lipo portion of the operation.  This can be extremely painful.

So, in essence, local anesthesia for very small cases, local and IV sedation for most moderate cases, and general anesthesia for very severe cases.

Dr Jacobs

[DrBermant]

I can't seem to find the thread about the different forms of anesthesia.
But, I believe that most doctors use Local Anesthesia with Sedation ?
Can you please verify which do use the majority of the time.
Thanks,
Mizuno

Plastic Surgery Anesthesia has evolved over the years.

I prefer local anesthesia alone for long nipple reduction gynecomastia. For almost all other gynecomastia surgery, local anesthesia with sedation provides a safer much more comfortable method.  When 2 stages are needed, as with this problem of enlarged nipples of gland and nipple tissue, I perform the first stage with local sedation, and the second with local alone.  For my upper body lift surgery, when I have to operate all around the chest - front / back, I need Light General Anesthesia.  This is still my Tumescent Technique, but adds the safety of airway protection while the patient is in the prone position.

I perform many revision gynecomastia surgery on patients first done elsewhere.  Many have told me how unpleasant their first doctor's experiences were under local anesthesia alone or General Anesthesia for liposuction and gynecomastia surgery.

You can find an extensive individual patients' experience with comfort and my Tumescent Technique Anesthesia for gynecomastia here.

If you prefer direct links to each of those discussions:

anesthesia and comfort in gynecomastia patient from California

anesthesia and comfort after revision gynecomastia surgery in patient from Hong Kong China

comfort and anesthesia in physician's son with gynecomastia

comfort and anesthesia in gynecomastia patient from Florida

comfort and anesthesia in gynecomastia patient from Illinois

comfort and anesthesia with gynecomastia patient from Texas

comfort after gynecomastia surgery with patient from Colorado

comparing comfort and anesthesia of my revision surgery with prior gynecomastia surgery in Florida

comfort and anesthesia in patient 4 hours from Richmond with gynecomastia

parent of teenage gynecomastia patient commenting about comfort after surgery

comfort after gynecomastia revision surgery on patient from the United Kingdom

comparing comfort of my revision surgery to prior gynecomastia surgery done in New York

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia Male Breast Reduction Surgery